Persistent Postural-Perceptual Dizziness (PPPD) is one of the most common types of chronic dizziness. The pathogenesis remains unclear.
This study aimed to systematically review neuroimaging literature for investigating the central mechanism of PPPD and related disorders.
PubMed, EMBASE, Medline, Cochrane,and Web of Science were searched by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles analyzing structural and functional neuroimaging features of PPPD and related disorders were selected according to eligibility criteria.
Fifteen articles, including 4 structural, 10 functional, and 1 multimodal imaging, were eligible for inclusion in this review. The whiter matter alterations in PPPD are not entirely consistent. The changes of grey matter mainly in multisensory vestibular cortices, visual cortex, cerebellum, as well as anxiety-related network. Consistent with structural imaging, functional imaging conducted during the specific tasks or in the resting state has both found abnormal functional activation and connectivity in the vestibular cortex, especially in the parieto-insular vestibular cortex (PIVC), visual cortex, cerebellum, and anxiety-related network in PPPD and related disorder.
The current review provides up-to-date knowledge and summarizes the possible central mechanism for PPPD and related disorders, and it is helpful to understanding the mechanism of PPPD.
The current review provides up-to-date knowledge and summarizes the possible central mechanism for PPPD and related disorders, and it is helpful to understanding the mechanism of PPPD.Voice change post-swallow, observed during a clinical swallow examination, is often used as a clinical indicator of dysphagia risk. However, there has been limited research that evaluated the level of agreement between voice change and swallow dysfunction reported to date. This systematic review aims to investigate existing evidence relating to the relationship between vocal change post-swallow and swallow deficits identified on a Videofluoroscopic Swallow Study (VFSS). The studies were selected by two independent evaluators for inclusion, without restriction on language or date of publication and the methodological quality and the risk of bias were assessed using QUADAS-2. Following the PRISMA recommendation, 271 articles were analyzed, of which 17 were included in the study. Of these, the methodology described in five studies employed voice analyses using only acoustic methods, seven others conducted only auditory-perceptual analyses, and five other studies used both. Across the studies there was no homogeneity in the voice quality parameters assessed, analytic methods used, and results obtained. Forty seven per cent of the studies presented a high risk of bias in the analysis of vocal quality due to lack of clarity and blinding of VFSS. https://www.selleckchem.com/products/aprocitentan.html There was no homogeneity in the choice of consistencies evaluated during swallowing, as well as standardization of the outcome investigated in VFSS without a vocal parameter attributable to accurate detection in each outcome. It is not possible to obtain a consensus regarding the recommendation of the use of vocal evaluation as an accurate method for identifying swallowing alterations due to heterogeneity of the vocal evaluation methods, the outcomes evaluated in the VFSS examination, heterogeneity in food and liquid consistencies, and the methodological quality of the studies.Cancer has been an important theme in literature, especially since the nineteenth century. Central dimensions of the frequent literary representations and interpretations of cancer are pathophenomenology, aetiology, diagnosis and therapy, image of the physician, subjectivity of the patient, medical institutions, social reactions and symbolism. The relationship between literature and medicine is a complex and reciprocal one marked by ontological differences. The long tradition of 'medical humanities' dating from ancient to present times is essential as human and humane medicine for the benefit and dignity of the suffering, sick and dying.Patient narratives are a very valuable literary and medical resource. They transcribe the experience of illness into the life stories of the subject and the author. A serious case of cancer triggers the very individual experience of vulnerability, suffering, dependence, and even contingency in the no longer 'open' future. Even after overcoming cancer, life is never the same again. Writing about one's own experience of cancer is a hermeneutic feat of strength with ethical and aesthetic implications. In the age of personalized and evidence-based medicine, patient narratives offer a particular and necessary supplement to the objectifying medical perspective, since they constitute expressions of subjective evidence. This article is based on the direct experience of cancer by the co-author of the narrative. The long history of her illness is presented chronologically in her own words and has been translated from Italian to English. This is followed by an essay, published here for the first time, on "the life beyond cancer", on the patient's time without tumors and the consequences of therapies and mutilating operations. Our methodological approach is based on Havi Carel's Phenomenology of Illness. The close reading of this pathography focuses on three aspects (1) the effect and power of words; (2) the passage from wariness to awareness; and (3) the maintenance of personal quality of life during and after cancer.Cancer is seen as a 'dread disease' with a long and powerful history that remains resistant to defeat. It is a byword for suffering, pain and death. An unprecedented level of research spending and biomedical engagement offering new treatment options and hopes for a cure goes hand in hand with patient-led movements disseminating widespread public narratives of hope and survivorship. A key paradigm in these public narratives of hope and cure has been early detection of disease, with breast cancer, as the most frequent cancer among women, at the forefront of early detection campaigns. This chapter investigates the experiences behind the public face of breast cancer. It interrogates what it means to have breast cancer in the light of heroic stories of survivorship and fight using the theoretical concepts of illness-the subjective experience of feeling unwell-and disease-bodily pathologies that are identified through biomedical diagnostic technologies. With early detection becoming the primary mode of practice in breast cancer, illness has to be re-conceptualized.